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Permissive Intrapartum Glucose Control 96

Abgeschlossen
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Die klinische Studie NCT05553275 untersuchte Schwangerschaftsdiabetes, Prägestationsdiabetes als interventionsstudie und hat den Status abgeschlossen. Die Studie begann am 5. Oktober 2022 mit 96 Teilnehmern. Sie wurde durchgeführt von The University of Texas Health Science Center, Houston und am 13. August 2023 abgeschlossen. Die Daten von ClinicalTrials.gov wurden zuletzt am 14. Mai 2024 aktualisiert.
Kurzbeschreibung
The purpose of this study is to assess whether permissive intrapartum glycemic control compared to usual care would lead to similar rate of neonatal hypoglycemia among people with diabetes.
Offizieller Titel

Permissive Intrapartum Glucose Control: An Equivalence Randomized Control Study (PERMIT)

Erkrankungen
SchwangerschaftsdiabetesPrägestationsdiabetes
Weitere Studien-IDs
  • HSC-MS-22-0577
NCT-Nummer
Studienbeginn (tatsächlich)
2022-10-05
Zuletzt aktualisiert
2024-05-14
Studienende (vorauss.)
2023-08-13
Geplante Rekrutierung
96
Studientyp
Interventionsstudie
PHASE
Nicht zutreffend
Status
Abgeschlossen
Stichwörter
Diabetes Mellitus
Primäres Ziel
Behandlung
Zuteilungsmethode
Randomisiert
Interventionsmodell
Parallel
Verblindung
Keine (offene Studie)
Studienarme/Interventionen
Teilnehmergruppe/StudienarmIntervention/Behandlung
Aktives VergleichspräparatGroup 1:Usual Care
Übliche Versorgung
Blood sugar evaluation (accuchecks) every four hours in latent labor and every 2 hours in active labor.Participants will be routinely managed with maintenance fluids of lactated ringers during latent labor and lactated ringers with dextrose 5% in active labor. Blood sugars of more than 110 mg/dl at any time point in labor will be treated with an insulin drip as follows: Regular insulin (100 units) in 100cc of normal...Mehr anzeigen
ExperimentellGroup 2: Permissive Care
Permissive intrapartum glucose control
Blood sugar evaluation (accuchecks) every four hours in latent labor and every 2 hours in active labor.Participants will be routinely management with maintenance fluids of lactated ringers during latent labor and lactated ringers with dextrose 5% in active labor.Blood sugars of more than 180 mg/dl at any time point in labor will be treated with an insulin drip as follows: Regular insulin (100 units) in 100cc of norm...Mehr anzeigen
Hauptergebnismessungen
ErgebnismessungBeschreibung der MessungZeitrahmen
first neonatal blood glucose level measured in mg/dL
up to 2 hours of life prior to first feed
Nebenergebnismessungen
ErgebnismessungBeschreibung der MessungZeitrahmen
Number of intrapartum glucose measurements
During Labor(for up to 200 hours)
Mean maternal glucose values in mg/dl
during latent labor(for up to 200 hours)
Mean maternal glucose values in mg/dl
during active labor(for up to 200 hours)
Overall mean maternal glucose values in mg/dl
in all of labor(for up to 200 hours)
Number of participants that have hyperglycemia episodes
Hyperglycemia is defined as blood sugar levels greater than 200 mg/dl
during labor( for up to 200 hours)
Number of participants that have hypoglycemia episodes
Hypoglycemia is defined as blood sugar levels less than or equal to 60 mg/dl or symptomatic or requiring IV dextrose
during labor(for up to 200 hours)
Number of participants that have Diabetic Ketoacidosis
Diabetic Ketoacidosis includes uncontrolled hyperglycemia, anion gap metabolic acidosis, and ketosis
during labor(for up to 200 hours)
Maximum insulin Glucose tolerance test (GTT) rate
during labor(for up to 200 hours)
Number of participants that utilize insulin drip
during labor(for up to 200 hours)
Number of participants that undergo primary cesarean section
at time of delivery
Number of participants that have Postpartum hemorrhage
Postpartum hemorrhage is defined as greater than or equal to 1000ml or need for blood transfusion
from discharge until 6 months after birth
Number pf participants that have Intra-amniotic Infection
Intra-amniotic Infection is defined as clinically diagnosed infection of the uterine environment
intrapartum or within 24 hours of delivery
Number pf participants that have endometriosis
Endometritis is defined as clinically diagnosed uterine infection
Between 24 hours after delivery to 6 weeks of delivery
Number pf participants that have wound complications
Wound complications is defined as superficial or deep infections, fascial dehiscence
within 6 weeks of delivery
Number pf participants that require blood product transfusion
during admission (for up to 6 weeks after neonate delivery)
Resource utilization during labor as assessed by the number of accuchecks done
during delivery admission (labor or induction/augmentation) until delivery defined as time patient is admitted to labor and delivery until birth time of neonate, for up to 200 hours
Resource utilization during labor as assessed by the number of nurses utilized
during delivery admission (labor or induction/augmentation) until delivery defined as time patient is admitted to labor and delivery until birth time of neonate, for up to 200 hours
Total facility and physician costs for all the services provided to the mothers
From maternal admission time to maternal discharge time(upto 6 months form admission date)
Total facility and physician costs for all the services provided to the neonates
from birth time to discharge time defined as birth time of neonate until neonate is discharged from the hospital, up to 1 year
Total nurse time cost for monitoring the patients during labor
From admission time to delivery time defined as time patient is admitted to labor and delivery until birth time of neonate, for up to 200 hours
Number of gestational diabetes participants that do an oral glucose tolerance test (OGTT)
within 6- 8 weeks of delivery
Neonatal C-peptide levels from cord blood
at time of delivery
Number of neonates that have blood glucose level less than 40 mg/dL
within the first 24 hours of life
Number of neonates that have blood glucose level less than 40 mg/dL
during birth admission defined as birth time of neonate until neonate is discharged from hospital, up to 1 year
Number of neonates that need oral glucose supplementation
during birth admission defined as birth time of neonate until neonate is discharged from hospital, up to 1 year
Number of neonates that need IV glucose
during birth admission defined as birth time of neonate until neonate is discharged from hospital, up to 1 year
Lowest neonatal glucose level
during birth admission defined as birth time of neonate until neonate is discharged from hospital, up to 1 year
Mean neonatal glucose level in first 24 hours of life
during birth admission defined as birth time of neonate until neonate is discharged from hospital, up to 1 year
Lowest neonatal glucose level
first 24 hours of life
Number of neonates that required shoulder dystocia
Shoulder dystocia is defined as the need for any extra maneuvers, other than gentle downward traction of the fetal head to deliver the fetal body after the fetal head has been delivered
at time of delivery
Number of neonates that had birth injury
Birth injury as defined as skull, clavicular, humerus fracture, or brachial plexus
from birth and during admission defined as birth time of neonate until neonate is discharged from hospital, up to 1 year
Number of neonates that had respiratory distress
Respiratory distress is defined as the need for at least 4 hours of respiratory support with supplemental oxygen, continuous positive airway pressure, or ventilation
first 24 hours of life
Number of fetal deaths
during labor defined as time patient is admitted to labor and delivery until birth time of neonate, for up to 200 hours
Number of neonatal deaths
within 28 days of birth
Number of neonates with Apgar score of less than 7
5 minutes from birth
Number of neonates that are admitted to Neonatal intensive care unit (NICU)
from birth up to 6 months from birth
Number of days neonates are admitted to NICU
from birth up to 6 months from birth
Number of neonates that have neonatal hyperbilirubinemia requiring phototherapy
during admission defined as birth time of neonate until neonate is discharged from hospital, up to 1 year
Maximum Bilirubin level
during admission defined as birth time of neonate until neonate is discharged from hospital, up to 1 year
Number of neonates that have hypocalcemia
during admission defined as birth time of neonate until neonate is discharged from hospital, up to 1 year
Number of neonates that have Necrotizing Enterocolitis
from birth up to 6 months from birth
Number of neonates that are small for gestational age
Small for gestational age is defined as a weight below 10th percentile of the expected value according to gestational age
at birth
Number of neonates that are large for gestational age
Large for gestational age is defined as a weight above 90th percentile of the expected value according to gestational age
at birth
Number of neonates that have Macrosomia
Macrosomia is defined as weight more than 4000 grams
at time of birth
Eignungskriterien

Zugelassene Altersgruppen
Erwachsene, Ältere Erwachsene
Mindestalter
18 Years
Zugelassene Geschlechter
Weiblich
  • Singleton gestation
  • Presenting for intrapartum management (induction, labor, augmentation)
  • Any diagnosis of Type 1 Diabetes Mellitus(T1DM), Type 2 Diabetes Mellitus (T2DM), or Gestational Diabetes
  • English or Spanish fluency

  • Major fetal anomalies affecting glucose metabolism
  • Multiple Gestation
  • Incarcerated subjects
  • less than 34 weeks gestation of pregnancy
  • Planned cesarean delivery
  • Utilizing insulin pump during labor
  • Stillbirth
  • Presenting in Diabetic ketoacidosis(DKA)
The University of Texas Health Science Center, Houston logoThe University of Texas Health Science Center, Houston
Verantwortliche Partei
Ghamar Bitar, Hauptprüfer, Fellow, The University of Texas Health Science Center, Houston
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1 Studienstandorte in 1 Ländern

Texas

The University of Texas Health Science Center at Houston, Houston, Texas, 77030, United States